Active NPI
Yvonne Marie Jenkins, PH.D.
- Clinical Psychologist
- Brookline, MA
National Provider Identifier
1154587962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3087
- Practice address
- 1415 Beacon St
Suite 222
Brookline, MA 02446-4816 - Phone
- (617) 739-0090
- NPI assigned
- Jul 31, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3087 | MA | Primary |
Addresses
Primary practice location
1415 Beacon St
Suite 222
Brookline, MA 02446-4816
Mailing address
1415 Beacon St
Suite 222
Brookline, MA 02446-4816
Phone (617) 739-0090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3087 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217462400000",
"number": "1154587962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1415 BEACON ST",
"address_2": "SUITE 222",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024464816",
"telephone_number": "617-739-0090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 BEACON ST",
"address_2": "SUITE 222",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024464816",
"telephone_number": "617-739-0090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "YVONNE",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-31",
"last_updated": "2008-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "3087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.